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项目 nGage:一项针对性活跃的年轻黑人性少数男性的随机对照试验的结果,该试验采用了一种双重网络支持干预措施来帮助他们保持在艾滋病毒护理中。

Project nGage: Results of a Randomized Controlled Trial of a Dyadic Network Support Intervention to Retain Young Black Men Who Have Sex With Men in HIV Care.

机构信息

School of Social Service Administration, University of Chicago, Chicago, IL, USA.

Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA.

出版信息

AIDS Behav. 2017 Dec;21(12):3618-3629. doi: 10.1007/s10461-017-1954-8.

Abstract

HIV-positive young black MSM (YBMSM) experience poor outcomes along the HIV care continuum, yet few interventions have been developed expressly for YBMSM retention in care. Project nGage was a randomized controlled trial conducted across five Chicago clinics with 98 HIV-positive YBMSM aged 16-29 between 2012 and 2015. The intervention used a social network elicitation approach with index YBMSM (n = 45) to identify and recruit a support confidant (SC) to the study. Each index-SC dyad met with a social worker to improve HIV-care knowledge, activate dyadic social support, and develop a retention in care plan. Each index and SC also received four mini-booster sessions. Control participants (n = 53) received treatment as usual. Surveys and medical records at baseline, 3-, and 12-months post-intervention assessed visit history (3 or more visits over 12 months; primary outcome), and sociodemographic, network, social-psychological, and behavioral factors. At baseline, there were no differences in age (M = 23.8 years), time since diagnosis (M ≤ 2 years), clinic visits in the previous 12 months (M = 4.1), and medication adherence (68.6 ≥ 90% adherence). In multivariate logistic regression analysis, intervention participants were 3.01 times more likely to have had at least 3 provider visits (95% CI 1.0-7.3) than were control participants over 12 months. Project nGage demonstrates preliminary efficacy in improving retention in care among YBMSM. Results suggest that engaging supportive network members may improve key HIV care continuum outcomes.

摘要

HIV 阳性的年轻黑人男男性行为者(YBMSM)在 HIV 护理连续体中经历较差的结果,但很少有干预措施是专门为 YBMSM 保留在护理中而开发的。项目 nGage 是一项在五个芝加哥诊所进行的随机对照试验,共有 98 名年龄在 16-29 岁之间的 HIV 阳性 YBMSM 参与,研究时间为 2012 年至 2015 年。该干预措施采用社会网络启发方法,由索引 YBMSM(n=45)识别和招募支持密友(SC)参与研究。每对索引-SC 会面一次,与社会工作者一起提高 HIV 护理知识,激活对偶社会支持,并制定护理保留计划。每个索引和 SC 还接受四次小型助推器课程。对照组(n=53)接受常规治疗。基线、3 个月和 12 个月的调查和医疗记录评估了就诊历史(12 个月内就诊 3 次或以上;主要结局)以及社会人口统计学、网络、社会心理和行为因素。在基线时,年龄(M=23.8 岁)、诊断后时间(M≤2 年)、前 12 个月就诊次数(M=4.1)和药物依从性(68.6≥90%的依从性)没有差异。在多变量逻辑回归分析中,干预组在 12 个月内至少有 3 次就诊的可能性是对照组的 3.01 倍(95%CI 1.0-7.3)。项目 nGage 初步证明了在提高 YBMSM 护理保留方面的有效性。结果表明,让支持性的网络成员参与可能会改善关键的 HIV 护理连续体结局。

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